Form CMS-10466 Application Exemptions Shared Responsibility for FFM's

Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions (CMS-10466)

Appendix C - Affordability-SBE-Exemptions-Application

Exemption Applications - Eligibility for Exemptions

OMB: 0938-1190

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File Typeapplication/pdf
File TitleHealth Insurance Marketplace - Application for exemption for Individuals who are Unable to Afford Coverage and are in a State wi
SubjectHealth Insurance Marketplace, Application for Exemption, Shared Responsibility Payment for Individuals, Experienced Hardships
AuthorHealth Insurance Marketplace
File Modified2023-12-20
File Created2023-12-11

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